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Hiroyuki Arai
2006 Volume 43 Issue 5 Pages
549-553
Published: September 25, 2006
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Tsutomu Nakada
2006 Volume 43 Issue 5 Pages
554-559
Published: September 25, 2006
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especially along with echography of the circulatory diseases
Masayuki Matsumoto
2006 Volume 43 Issue 5 Pages
560-565
Published: September 25, 2006
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Hideyuki Hattori
2006 Volume 43 Issue 5 Pages
566-568
Published: September 25, 2006
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Hiromi Rakugi, Toshio Ogihara
2006 Volume 43 Issue 5 Pages
569-573
Published: September 25, 2006
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Takashi Ohrui
2006 Volume 43 Issue 5 Pages
574-577
Published: September 25, 2006
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Mayumi Mori
2006 Volume 43 Issue 5 Pages
578-581
Published: September 25, 2006
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Kazutetsu Aoshiba
2006 Volume 43 Issue 5 Pages
582-584
Published: September 25, 2006
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Ryuichi Ajisaka
2006 Volume 43 Issue 5 Pages
585-587
Published: September 25, 2006
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Kunio Yano
2006 Volume 43 Issue 5 Pages
588-590
Published: September 25, 2006
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Yukihiko Momiyama
2006 Volume 43 Issue 5 Pages
591-594
Published: September 25, 2006
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Masao Nagata
2006 Volume 43 Issue 5 Pages
595-597
Published: September 25, 2006
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Tatsuya Koike
2006 Volume 43 Issue 5 Pages
598-601
Published: September 25, 2006
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Takahide Nagase
2006 Volume 43 Issue 5 Pages
602-603
Published: September 25, 2006
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Toshihiko Iwamoto
2006 Volume 43 Issue 5 Pages
604-607
Published: September 25, 2006
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Ryutaro Takahashi
2006 Volume 43 Issue 5 Pages
608-609
Published: September 25, 2006
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relationship with APOE genotype
Noriaki Mitsuda
2006 Volume 43 Issue 5 Pages
610-612
Published: September 25, 2006
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Yumiko Fukuoka, Reiko Hatakeyama, Aiko Hatakeyama, Atsuko Sato, Hideta ...
2006 Volume 43 Issue 5 Pages
613-615
Published: September 25, 2006
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A pilot study based on the Simple Test for Evaluating Hand Function
Mika Sakamoto, Emiko Kikuchi, Masahiro Shigeta
2006 Volume 43 Issue 5 Pages
616-621
Published: September 25, 2006
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Aim: The purpose of this study was to analyze the levels of recognition and hand functions of the patients with Alzheimer's disease (AD) based on the Simple Test for Evaluating Hand Function (STEF).
Methods: Forty subjects with AD (AD group) and 20 without AD (control group) in a facility for elderly health care services participated in this study. The AD group consisted of 20 subjects with Clinical Dementia Rating (CDR) 1 and 20 other subjects with CDR2.
Results: The results were as follows: Time required for full motion of right hand dexterity was significantly longer in both the CDR1 and CDR2 groups compared to the control group (p<0.05, p<0.01). Time required for the control group and CDR1 group were significantly shorter for motion of right hand dexterity compared to the left hand. No significant difference was observed between the times of right and left hand dexterity among subjects of CDR2. The disparity of right-left hand dexterity decreased in the order of control, CDR1 and CDR2. The correlations between the sub-items for CDR scale and the right-left hand disparity were significant in “memory” and “judgment”. The right-left hand disparity decreased with the shortened time for left hand motion, as the “memory” or “judgment” scores increased.
Conclusion: These findings suggest that right hand dexterity speed in patients in the mild AD stage was low when their dominant hand superiority declined. Moreover the decline of dominant hand superiority correlated with the recognition of memory and judgment.
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Tsutomu Yamada, Sumie Ohni, Masako Mitsumata, Takahiro Ueno, Kenji Ueh ...
2006 Volume 43 Issue 5 Pages
622-629
Published: September 25, 2006
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Aim: The ubiquitin proteasome system (UPS) is important because homeostasis through proteolysis and ubiquitin (Ub) has been observed to appear in diseases of the central nervous system. However, studies on UPS in relation to pulmonary diseases are few and no other investigators have described Ub-positive cells in the lung. Intracytoplasmic eosinophilic inclusion bodies in pneumocytes have been known to appear in cases of diffuse alveolar damage (DAD). We found that these inclusion bodies in DAD were positive for Ub. In this study, DAD cases in the elderly were studied to clarify the relationship between Ub-positive cells and cellular damage in the lungs.
Methods: Representative lung fields from a total of 26 patients with DAD were studied immunohistochemically, using Ub staining. The severity of DAD was evaluated after each case was scored for hyaline membrane formation and lung injury, respectively. Non-DAD diseases from 19 autopsy cases were studied as controls. The mean age of both groups was 72.1.
Results: Variably sized and shaped eosinophilic inclusion bodies were found in 7 cases (26.9%) of the DAD cases (inclusion body group) and all inclusion bodies were positive for Ub and cytokeratin KL-1. Pneumocytes without inclusion bodies were occasionally positive for Ub, with an intracytoplasmic granular pattern, not only in the inclusion body group but also in the non-inclusion body group (4 of DAD cases). These Ub-positive cells (both Ub-positive inclusion bodies and the granular Ubpositive cells) were found to have high rate of hyaline membrane formation and lung injury in the DAD cases.
Conclusion: Elderly DAD cases had Ub-positive inclusion bodies in pneumocytes and Ub-positive pneumocytes were found with or without the inclusion bodies in DAD. This means that accumulation of ubiquitinated protein including cytokeratin could be recognized as inclusion bodies in pneumocytes. The presence of these Ub-positive cells might be a morphological indicator for evaluation of cellular damage in the patients with DAD.
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Eiichi Sudo, Hiroaki Kitade, Tsunemi Kitagawa, Minoru Kawaguchi
2006 Volume 43 Issue 5 Pages
630-634
Published: September 25, 2006
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Aim: To educate patients with chronic respiratory disease about respiratory diseases and pulmonary rehabilitation, a respiratory education class was held for patients with chronic respiratory diseases and their families. In this study, we evaluated the psychological effects of the class.
Methods: The respiratory education class was held twice during the 2-year period (2002-2004) while the physician specializing in geriatric and respiratory diseases worked at the hospital. Before, during, and one year after the class, we investigated the mental and physical condition in 24 chronic respiratory patients (aged 72.7±1.3 years) using the State-Trait Anxiety Inventory (STAI) to measure anxiety, the Self Rating Depression Scale (SDS) to evaluate depressive state, and the General Self-Efficacy Scale (GSES) to evaluate self efficacy.
Results: Before, during, and one year after the class, the mean STAI scores were 39.2±2.5, 40.0±2.5, and 39.4±2.7, the mean SDS scores were 37.6±2.2, 37.0±2.0, and 38.0±2.0, and the mean GSES scores were 7.4±0.7, 8.0±0.8, and 8.6±0.8, respectively. No statistically significant difference was observed for scores on the STAI, SDS between the time points. The score during the class significantly (p<0.05) increased compared to the score before the class, and remained significantly increased one year after the class on the GSES.
Conclusion: These results suggest that conducting a respiratory education class might be beneficial for patients with chronic respiratory disease.
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Goh Ohji, Masao Nagata, Kenta Hara, Toshioki Matsuzawa, Noriyuki Hata, ...
2006 Volume 43 Issue 5 Pages
635-638
Published: September 25, 2006
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An 80-year-old woman with type II diabetes mellitus was admitted to hospital with high-grade fever and leg pain for the previous three days. Physical examination revealed marked distention of the peripheral veins in both lower legs and she complained of pain.
Spontaneous superficial suppurative thrombophlebitis was diagnosed and transfusion of cefazolin every 8 hours was started immediately after blood cultures. After 48 hours, the distention of the peripheral veins was improved; however, she suffered from a severe back pain thereafter. Two sets of blood culture yielded Group B
streptococcus. Therefore the antibiotic was changed to ampicillin every 6 hours.
To investigate the cause of back pain, MRI of the lumbar vertebral body was taken. Saggital gadolinium T1-weighted MRI demonstrated a high signal intensity lesion from Th7 to Th11, suggesting vertebral osteomyelitis following Group B streptococcal bacteremia from superficial suppurative thrombophlebitis. One week later, the clinical symptoms mostly disappeared. After six weeks of treatment, she was discharged.
Suppurative thrombophlebitis is an inflammation of the vein wall by microorganisms and sometimes causes secondary metastatic abscess. Aging and diabetes are also risk factors for group B streptococcal invasive infection.
This case suggests vertebral osteomyelitis should be taken into consideration during the course of group B streptococcal bacteremia in an elderly patient complaining back pain.
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Masayuki Ochi, Michiya Igase, Ayako Nagai, Syunpei Nakamura, Tokihisa ...
2006 Volume 43 Issue 5 Pages
639-642
Published: September 25, 2006
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A 52-year-old woman with diabetes mellitus (DM) complained of weakness of the arms and legs. She was referred to our hospital in November 2002 because of anemia, thyroid tumor and meningioma including DM. She was short in stature, juvenile bilateral cataract, intractable skin ulcers, clavus on the sole of her foot, a bird-like face and high-pitched voice. Typical physical features led to the final diagnosis of Werner's syndrome. Although the myelogram revealed no abnormal findings except erythroid hypoplasia, cytogenetic analysis of bone marrow cells showed deletion of chromosome 20 in 10% of the analyzed cells, which suggested the possibility of that myelodysplastic syndrome (MDS) or acute myeloblastic leukemia (AML) could occur. She had a thyroidectomy because both lobes of the thyroid gland were enlarged and caused hoarseness, In addition, it is common knowledge that the goiter could become malignant. We need to follow her carefully because she might be vulnerable to malignant disease, including leukemia and malignant meningioma.
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Michiko Matsukawa, Shinji Teramoto, Yasuhiro Yamaguchi, Masato Eto, Hi ...
2006 Volume 43 Issue 5 Pages
643-647
Published: September 25, 2006
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We report an elderly case with nontuberculous mycobacteria (NTM). Four years after left lung upper lobectomy due to lung cancer by the video-assisted thoracic surgery (VATS), an 81 year-old patient complained of general fatigue and appetite loss. Although he did not exhibit fever or respiratory tract symptoms, a Chest X ray film revealed unilateral massive pleural effusion in the left lung. NTM (Runyon classification type II) was grown in the sputum culture. Neither mycobacterium tuberculosis DNA nor M. avium-intracellulare complex DNA was detected by polymerase chain reaction. The pleural effusion adenosine deaminase (ADA) activity was 127.6U/
l. NTM was considered as the most probable diagnosis. After admission his condition and appetite improved. Chest computed tomography (CT) scan showed reduction of left pleural effusion, but another pulmonary nodule lesions were sustained. Although the abnormal findings on chest CT did not totally resolve, we did not prescribe antituberculosis drugs, based on the comprehensive assessment of his NTM disease state. The pathogenesis and diagnosis of HTM in elderly cases was discussed.
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2006 Volume 43 Issue 5 Pages
648-661
Published: September 25, 2006
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